| NPI | 1790220879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95044219) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2021-07-07 |