| NPI | 1275179871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95013025) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95138707) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-12-31 |