NPI | 1417200908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19169) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 19169) |
163W00000X Registered Nurse (Licence: CA 673910) | |
Enumeration Date | 2012-10-21 |
Last Update Date | 2017-09-05 |