NPI | 1114646551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025550) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: CA 95166671) |
Enumeration Date | 2022-08-26 |
Last Update Date | 2024-12-12 |