NPI | 1477039808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011398) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012463) |
Enumeration Date | 2018-07-18 |
Last Update Date | 2021-02-26 |