| NPI | 1669856654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95081993) |
| 163W00000X Registered Nurse (Licence: NY 688593-1) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2016-12-26 |