NPI | 1629657929 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016467) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI 4154-0) |
Enumeration Date | 2021-04-05 |
Last Update Date | 2025-04-24 |