NPI | 1740038769 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95035066) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95164604) |
Enumeration Date | 2024-05-07 |
Last Update Date | 2025-08-19 |