| NPI | 1518355684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95003714) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95047968) |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2017-03-22 |