NPI | 1740716984 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006578) |
Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA 95006578) |
Enumeration Date | 2017-05-09 |
Last Update Date | 2020-02-12 |