NPI | 1770108151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010772) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95010772) |
Enumeration Date | 2020-06-11 |
Last Update Date | 2025-09-05 |