NPI | 1972292654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352154) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1114292) |
Enumeration Date | 2023-05-08 |
Last Update Date | 2023-06-14 |