| NPI | 1053819961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 818501) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |