NPI | 1083265565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95012757) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 749649) |
Enumeration Date | 2019-09-25 |
Last Update Date | 2022-10-07 |