| NPI | 1104351121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010175) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 822343) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2018-11-19 |