NPI | 1720671662 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95029890) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29074) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11015370) | |
Enumeration Date | 2021-02-11 |
Last Update Date | 2024-07-02 |