NPI | 1508069071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010757) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 4360) |
363LF0000X Nurse Practitioner, Family (Licence: ID 1371-a) | |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL 2979752) | |
Enumeration Date | 2007-06-11 |
Last Update Date | 2020-04-09 |