NPI | 1043794373 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95014223) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 53-78330-081) |
207R00000X Internal Medicine (Licence: CA 95014223) | |
363LF0000X Nurse Practitioner, Family (Licence: CA 95014223) | |
Enumeration Date | 2018-09-22 |
Last Update Date | 2023-02-24 |