NPI | 1306563754 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023874) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95317797) |
163WP2201X Registered Nurse, Ambulatory Care (Licence: VT 026.0140134) | |
Enumeration Date | 2022-10-26 |
Last Update Date | 2023-03-18 |