NPI | 1619315231 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004694) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337956) |
Enumeration Date | 2013-06-05 |
Last Update Date | 2021-09-25 |