NPI | 1780094490 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132550) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 15638) |
Enumeration Date | 2014-05-02 |
Last Update Date | 2020-01-06 |