NPI | 1508480120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013826) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95158487) |
Enumeration Date | 2020-05-29 |
Last Update Date | 2022-12-07 |