NPI | 1366954620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006273) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 11286) |
363LF0000X Nurse Practitioner, Family (Licence: NH 088676-23) | |
363LF0000X Nurse Practitioner, Family (Licence: RI APRN03136) | |
Enumeration Date | 2017-10-26 |
Last Update Date | 2023-04-19 |