NPI | 1932617156 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008362) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020005) |
Enumeration Date | 2018-01-22 |
Last Update Date | 2023-04-27 |