NPI | 1508404229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013241) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95136868) |
Enumeration Date | 2019-12-12 |
Last Update Date | 2024-10-28 |