NPI | 1225548175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006029) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA 95006029) |
Enumeration Date | 2017-10-05 |
Last Update Date | 2021-11-10 |