NPI | 1255987517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95012424) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95137673) |
Enumeration Date | 2019-08-13 |
Last Update Date | 2021-12-07 |