NPI | 1114541117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014544) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95014544) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95014544) | |
Enumeration Date | 2020-06-04 |
Last Update Date | 2022-03-30 |