| NPI | 1790248417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 715107) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2020-09-12 |