NPI | 1083455257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95179765) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95179765) |
Enumeration Date | 2024-06-03 |
Last Update Date | 2024-10-31 |