NPI | 1053766808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014184) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 238136) |
Enumeration Date | 2016-04-29 |
Last Update Date | 2021-11-30 |