NPI | 1356789879 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 22854) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 22854) |
Enumeration Date | 2013-06-06 |
Last Update Date | 2023-10-30 |