NPI | 1720667793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021071) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN290078) |
Enumeration Date | 2021-04-06 |
Last Update Date | 2024-06-13 |