| NPI | 1164826764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007808) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 814949) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2017-11-22 |