NPI | 1972100766 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95026529) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008363) |
Enumeration Date | 2020-10-05 |
Last Update Date | 2024-01-10 |