| NPI | 1073901138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009446) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2281879) |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2018-11-13 |