NPI | 1508378563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95018183) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 342276) |
Enumeration Date | 2017-10-31 |
Last Update Date | 2021-12-16 |