NPI | 1639558224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95002202) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 760280) |
163WC1400X Registered Nurse, College Health (Licence: CA 760280) | |
Enumeration Date | 2015-05-28 |
Last Update Date | 2016-01-04 |