| NPI | 1063816882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95001327) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 794846) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP95001327) | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2018-05-04 |