| NPI | 1194073692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004766) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 150397) |
| 363L00000X Nurse Practitioner (Licence: WI 5237) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2022-11-29 |