| NPI | 1790202778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007336) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 800419) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-03-27 |