NPI | 1609416205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013588) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 143942) |
Enumeration Date | 2020-01-10 |
Last Update Date | 2021-05-12 |