| NPI | 1629690946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95016654) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 9502258) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2021-07-22 |