NPI | 1215546767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95017081) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2328901) |
Enumeration Date | 2020-07-29 |
Last Update Date | 2023-04-01 |