| NPI | 1639577000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95002136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 786137) |
| 363L00000X Nurse Practitioner (Licence: CA 95002136) | |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2018-03-17 |