| NPI | 1063879633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015785) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 00000) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2023-09-11 |