NPI | 1124386347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010621) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 664986) |
Enumeration Date | 2012-04-25 |
Last Update Date | 2019-06-18 |