NPI | 1912557786 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013695) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142950) |
Enumeration Date | 2019-09-13 |
Last Update Date | 2021-04-09 |