NPI | 1477274215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95020466) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 95020466) |
207QA0505X Family Medicine, Adult Medicine (Licence: CA 95020466) | |
208D00000X General Practice (Licence: CA 95020466) | |
Enumeration Date | 2022-09-09 |
Last Update Date | 2025-01-08 |