NPI | 1558619015 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016792) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP121988) |
Enumeration Date | 2012-08-15 |
Last Update Date | 2022-03-08 |