NPI | 1073106225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025235) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2337842) |
Enumeration Date | 2021-02-18 |
Last Update Date | 2024-05-05 |