NPI | 1194375568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016983) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95130677) |
Enumeration Date | 2019-09-17 |
Last Update Date | 2024-08-18 |