NPI | 1912300773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95000619) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 478063) |
Enumeration Date | 2014-10-07 |
Last Update Date | 2014-10-07 |