NPI | 1770902124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN238548) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 850946) |
164X00000X Licensed Vocational Nurse (Licence: CA 254771) | |
Enumeration Date | 2014-04-14 |
Last Update Date | 2024-05-10 |