NPI | 1417436197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010433) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000024582) |
Enumeration Date | 2018-08-13 |
Last Update Date | 2024-08-31 |