| NPI | 1619256625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 20790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 784019) |
| 163W00000X Registered Nurse (Licence: NY 616259-1) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F336674-1) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2020-05-28 |