| NPI | 1639558174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 753133) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 753133) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |