NPI | 1205192713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019912) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337101) |
Enumeration Date | 2012-04-09 |
Last Update Date | 2022-06-23 |