NPI | 1588196612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 259350) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA RN800297) |
Enumeration Date | 2017-03-29 |
Last Update Date | 2025-02-17 |