NPI | 1962142422 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 872200070) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 872200070) |
Enumeration Date | 2022-03-31 |
Last Update Date | 2025-06-03 |