NPI | 1659668325 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 17821) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 571171) |
Enumeration Date | 2011-07-01 |
Last Update Date | 2011-07-01 |