NPI | 1609479682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95016552) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1015154) |
Enumeration Date | 2020-11-20 |
Last Update Date | 2024-06-21 |