| NPI | 1558825935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95049683) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95007599) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA F05180655) | |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-02-18 |