NPI | 1003524844 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95020930) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN639296) |
Enumeration Date | 2022-11-10 |
Last Update Date | 2023-11-15 |