NPI | 1356095590 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021046) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95071278) |
Enumeration Date | 2022-02-07 |
Last Update Date | 2023-03-29 |