NPI | 1871091629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008437) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95008437) |
Enumeration Date | 2018-01-26 |
Last Update Date | 2020-06-23 |