| NPI | 1629439567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 22897) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 686404) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-04-08 |