NPI | 1205484771 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95012529) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95012529) |
Enumeration Date | 2019-08-28 |
Last Update Date | 2023-11-20 |