NPI | 1760074777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015766) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2021-02-10 |
Last Update Date | 2022-08-23 |