NPI | 1912480567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 348597-4405) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 348597-4405) |
Enumeration Date | 2018-09-10 |
Last Update Date | 2024-06-20 |