NPI | 1659912384 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95018237) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME 70453) |
Enumeration Date | 2019-10-03 |
Last Update Date | 2022-01-05 |