NPI | 1811921257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15124) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA 60572096) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2015-09-03 |