NPI | 1104479302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0994940-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60938809) |
163WG0000X Registered Nurse, General Practice (Licence: CO RN.0205201) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60975919) | |
Enumeration Date | 2019-07-17 |
Last Update Date | 2019-12-23 |