NPI | 1508306176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95003901) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA 95003901) |
Enumeration Date | 2017-03-02 |
Last Update Date | 2022-08-19 |