NPI | 1063854446 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011355) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5122) |
Enumeration Date | 2013-07-25 |
Last Update Date | 2019-03-15 |