NPI | 1215578562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95012833) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-189904) |
Enumeration Date | 2019-10-07 |
Last Update Date | 2022-03-22 |