NPI | 1609487529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019027) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95139331) |
Enumeration Date | 2020-08-13 |
Last Update Date | 2022-03-29 |