NPI | 1720404163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000357) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 774849) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9298698) | |
Enumeration Date | 2014-03-10 |
Last Update Date | 2019-11-06 |