NPI | 1588242002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017979) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71010996A) |
Enumeration Date | 2021-03-29 |
Last Update Date | 2021-08-17 |