NPI | 1508492471 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016108) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95219761) |
Enumeration Date | 2020-03-22 |
Last Update Date | 2021-09-04 |