NPI | 1811409774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 76405953102) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT F09170522) |
Enumeration Date | 2017-11-01 |
Last Update Date | 2024-02-27 |