NPI | 1407401342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017258) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2320716) |
Enumeration Date | 2019-08-07 |
Last Update Date | 2021-05-07 |