NPI | 1649261223 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95020407) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 97006277) |
363LF0000X Nurse Practitioner, Family (Licence: OR 097006277N1) | |
Enumeration Date | 2005-11-02 |
Last Update Date | 2025-08-28 |