NPI | 1578962312 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95000975) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95000975) |
Enumeration Date | 2014-08-18 |
Last Update Date | 2022-08-23 |