NPI | 1962785733 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18727) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166115) |
363LF0000X Nurse Practitioner, Family (Licence: CT 1753) | |
Enumeration Date | 2011-09-27 |
Last Update Date | 2020-11-13 |