NPI | 1255586293 |
---|---|
Former Name | JANE IVORY ERNSTTHAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18361) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 651984) |
Enumeration Date | 2008-11-18 |
Last Update Date | 2025-04-07 |