| NPI | 1063092138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017752) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 758290) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-07-27 |