NPI | 1770354342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1095920) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1095920) |
363LF0000X Nurse Practitioner, Family (Licence: NY 350561) | |
Enumeration Date | 2024-01-12 |
Last Update Date | 2024-01-12 |