NPI | 1114275336 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95005434) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 495309) |
Enumeration Date | 2012-08-20 |
Last Update Date | 2017-04-20 |