NPI | 1932425097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127894) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA11430-NP) |
Enumeration Date | 2010-04-14 |
Last Update Date | 2020-11-20 |