NPI | 1639413404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA NP95013223) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024170493) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 2017234) | |
Enumeration Date | 2012-11-19 |
Last Update Date | 2020-02-19 |