NPI | 1376909770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201702046) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 53104) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95003479) | |
Enumeration Date | 2016-01-14 |
Last Update Date | 2024-02-05 |