NPI | 1699380667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017605) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024180089) |
Enumeration Date | 2020-09-15 |
Last Update Date | 2022-10-31 |