| NPI | 1699212779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-180218) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 11485) |
| 363L00000X Nurse Practitioner (Licence: OR 201801167NP-PP) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2022-03-03 |