NPI | 1104082155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 9042) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 531129) |
Enumeration Date | 2008-07-30 |
Last Update Date | 2024-08-29 |