NPI | 1780133959 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008696) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132070) |
Enumeration Date | 2016-09-28 |
Last Update Date | 2022-07-21 |