NPI | 1003166414 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021841) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1126033) |
Enumeration Date | 2012-09-12 |
Last Update Date | 2022-08-16 |