NPI | 1497159495 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002511) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95062474) |
363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000766) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: DE LG0000766) | |
Enumeration Date | 2014-10-20 |
Last Update Date | 2018-07-19 |