NPI | 1225687213 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95031044) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-09-11 |
Last Update Date | 2024-09-14 |