| NPI | 1619462736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009374) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95040025) |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2018-07-17 |