| NPI | 1588379168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95026784) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704352935) |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-11-07 |