NPI | 1750056255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95018089) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 95018089) |
Enumeration Date | 2021-08-16 |
Last Update Date | 2025-02-12 |