| NPI | 1174033062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95005381) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 781123) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA f08170836) | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |