NPI | 1144784158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010568) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95010568) |
Enumeration Date | 2019-01-23 |
Last Update Date | 2022-10-24 |