NPI | 1972890283 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A003557) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1766) |
363LF0000X Nurse Practitioner, Family (Licence: OK 87408) | |
Enumeration Date | 2011-07-07 |
Last Update Date | 2021-12-30 |