| NPI | 1023632023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: CA 399426) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CA CCS00042F) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2021-03-10 |