| NPI | 1114368628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95006472) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95022822) |
| 163W00000X Registered Nurse (Licence: PA RN654334) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP013818) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2018-03-17 |