| NPI | 1669704797 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 079042857RN) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 217429) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |