| NPI | 1093706350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 15291) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 562830) |
| 363A00000X Physician Assistant (Licence: CA 17617) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2025-01-03 |