| NPI | 1164068268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 161969) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 161968) |
| 163W00000X Registered Nurse (Licence: CA 95154363) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95013748) | |
| Enumeration Date | 2019-11-23 |
| Last Update Date | 2022-09-26 |