| NPI | 1194261115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95005592) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95005592) |
| Enumeration Date | 2017-01-14 |
| Last Update Date | 2020-11-18 |