NPI | 1104331735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007941) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007941) |
Enumeration Date | 2017-12-05 |
Last Update Date | 2024-01-17 |