| NPI | 1790175214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 836079) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2022-04-07 |