NPI | 1063078806 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009121) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95079580) |
363L00000X Nurse Practitioner (Licence: CA 95009121) | |
Enumeration Date | 2019-05-16 |
Last Update Date | 2023-08-16 |