NPI | 1962058172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015699) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 230050) |
Enumeration Date | 2019-08-13 |
Last Update Date | 2023-06-28 |