NPI | 1043813280 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016015) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95160696) |
Enumeration Date | 2020-11-19 |
Last Update Date | 2020-12-30 |