NPI | 1518097450 |
---|---|
Former Name | MINETTE PLAZA PETAGARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 14325) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 505303) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2021-09-17 |