NPI | 1740773522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009608) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN261803) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2019-10-01 |