NPI | 1174265151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95024811) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022034478) |
Enumeration Date | 2022-04-11 |
Last Update Date | 2025-02-04 |