NPI | 1548799059 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016348) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 717070) |
163WG0000X Registered Nurse, General Practice (Licence: PA RN697842) | |
363LF0000X Nurse Practitioner, Family (Licence: PA SP018660) | |
Enumeration Date | 2017-06-08 |
Last Update Date | 2021-02-01 |