| NPI | 1376853374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 61630) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 717919) |
| 363L00000X Nurse Practitioner (Licence: NM CNP-61630) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA F0413125) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21504) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 61630) | |
| Enumeration Date | 2010-10-09 |
| Last Update Date | 2021-12-08 |