| NPI | 1154949972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 155846) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-09-03 |