NPI | 1770240434 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017629) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95017629) |
Enumeration Date | 2021-11-17 |
Last Update Date | 2022-11-14 |