NPI | 1225155567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95029626) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN 116911) |
163W00000X Registered Nurse (Licence: TN RN 152036) | |
363LF0000X Nurse Practitioner, Family (Licence: LA APRN 05099) | |
Enumeration Date | 2007-03-23 |
Last Update Date | 2024-10-09 |