NPI | 1891061982 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95004977) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004977) |
Enumeration Date | 2012-03-22 |
Last Update Date | 2018-07-13 |