| NPI | 1164506663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95011951) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 069742) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-05-22 |