NPI | 1558639716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95027481) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95089143) |
164X00000X Licensed Vocational Nurse (Licence: CA VN258972) | |
Enumeration Date | 2011-12-02 |
Last Update Date | 2024-02-09 |