NPI | 1790261634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019802) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95145492) |
Enumeration Date | 2018-07-13 |
Last Update Date | 2023-11-13 |