| NPI | 1124537790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 95002990) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 781009) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-03-02 |