| NPI | 1770084246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008304) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 1116630) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-02-21 |