NPI | 1679112007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 950141007) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 791877) |
Enumeration Date | 2020-01-02 |
Last Update Date | 2020-07-06 |