NPI | 1124697388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95024163) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95198557) |
Enumeration Date | 2021-06-22 |
Last Update Date | 2023-04-26 |