NPI | 1245467992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 18743) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 18743) |
Enumeration Date | 2009-06-19 |
Last Update Date | 2017-10-26 |