NPI | 1548883002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017155) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA F05200314) |
Enumeration Date | 2020-05-19 |
Last Update Date | 2021-06-25 |