NPI | 1356981526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013240) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 80555) |
Enumeration Date | 2020-01-15 |
Last Update Date | 2021-10-21 |