NPI | 1679812655 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 255675) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP 22476) |
Enumeration Date | 2013-02-11 |
Last Update Date | 2021-09-23 |