NPI | 1790210284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006424) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 779095) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP133847) | |
Enumeration Date | 2017-04-22 |
Last Update Date | 2023-09-14 |