NPI | 1962038661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140989) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN209221) |
Enumeration Date | 2020-03-14 |
Last Update Date | 2020-03-14 |