NPI | 1407520810 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95025362) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046949) |
Enumeration Date | 2021-08-09 |
Last Update Date | 2025-03-07 |