NPI | 1396267043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95025249) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343419) |
Enumeration Date | 2017-07-14 |
Last Update Date | 2024-08-13 |