| NPI | 1962562769 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 508639) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: CA 508639) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-10-27 |