NPI | 1619435815 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011187) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95011187) |
Enumeration Date | 2019-03-06 |
Last Update Date | 2021-10-14 |