| NPI | 1639543994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19640) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 515900) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2020-04-27 |