NPI | 1164963716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008207) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R215956) |
363LA2200X Nurse Practitioner Adult Health (Licence: CA 95008207) | |
363LG0600X Nurse Practitioner Gerontology (Licence: CA 95008207) | |
Enumeration Date | 2017-03-15 |
Last Update Date | 2021-05-11 |