NPI | 1770021230 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95009232) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009232) |
Enumeration Date | 2017-02-05 |
Last Update Date | 2018-06-18 |