NPI | 1194261115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005592) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95005592) |
Enumeration Date | 2017-01-14 |
Last Update Date | 2020-11-18 |