NPI | 1861915993 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011416) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07170933) |
Enumeration Date | 2017-07-20 |
Last Update Date | 2022-01-18 |