| NPI | 1134792153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 611123) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 18489) |
| 363L00000X Nurse Practitioner (Licence: CA 16513) | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-09-04 |