| NPI | 1154929495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017058) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 374283) |
| 163WC1500X Registered Nurse, Community Health (Licence: CA 374283) | |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2021-04-11 |