NPI | 1447732409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010112) |
Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CA 8003962210) |
Enumeration Date | 2018-09-05 |
Last Update Date | 2019-07-08 |