NPI | 1730557596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005432) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76926) |
Enumeration Date | 2015-09-10 |
Last Update Date | 2017-02-01 |