| NPI | 1245887132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011484) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11001330) |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2019-08-24 |