NPI | 1558819649 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95005326) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95005326) |
363LF0000X Nurse Practitioner, Family (Licence: CA 2005041) | |
Enumeration Date | 2016-09-16 |
Last Update Date | 2021-04-20 |