NPI | 1083114508 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008068) |
Additional Taxonomies | 163WE0900X Registered Nurse, Enterostomal Therapy (Licence: CA 95008068) |
Enumeration Date | 2018-02-21 |
Last Update Date | 2021-05-24 |