NPI | 1972081701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017824) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI APRN01869) |
Enumeration Date | 2018-08-02 |
Last Update Date | 2021-10-05 |