| NPI | 1457978413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015080) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95066473) | 
| Enumeration Date | 2020-06-25 | 
| Last Update Date | 2020-08-18 |