NPI | 1770077729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009234) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344267) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2022-09-03 |