NPI | 1659066165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95030413) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001354) |
363LF0000X Nurse Practitioner, Family (Licence: NH 071665-23) | |
Enumeration Date | 2023-04-10 |
Last Update Date | 2024-08-17 |