NPI | 1134888530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019418) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95233635) |
Enumeration Date | 2021-12-13 |
Last Update Date | 2022-06-24 |