| NPI | 1639602766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95006380) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 790440) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |