| NPI | 1780233411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95012677) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 845922) |
| 364S00000X Clinical Nurse Specialist (Licence: CA 4829) | |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-10-05 |