NPI | 1053894717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013662) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F343571) |
Enumeration Date | 2018-09-10 |
Last Update Date | 2024-08-20 |