NPI | 1174030506 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007845) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA NP95007845) |
Enumeration Date | 2018-01-08 |
Last Update Date | 2019-12-11 |