NPI | 1790237485 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005154) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95005154) |
Enumeration Date | 2016-10-27 |
Last Update Date | 2018-06-11 |