NPI | 1720552722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014687) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95166127) |
Enumeration Date | 2019-01-14 |
Last Update Date | 2020-07-27 |