NPI | 1740936111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95020848) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95156349) |
Enumeration Date | 2022-02-24 |
Last Update Date | 2022-05-11 |