NPI | 1194118836 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-194006) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001662) |
Enumeration Date | 2015-03-05 |
Last Update Date | 2022-04-18 |