NPI | 1497390892 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95018825) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95097433) |
Enumeration Date | 2019-11-10 |
Last Update Date | 2021-10-19 |