| NPI | 1790409464 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 9763) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95326849) |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2024-08-12 |