| NPI | 1740919414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019318) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 798947) | 
| Enumeration Date | 2022-06-08 | 
| Last Update Date | 2022-06-10 |