NPI | 1336631407 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007951) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95007951) |
Enumeration Date | 2018-06-04 |
Last Update Date | 2024-01-31 |