| NPI | 1790256659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN95170489) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2022-06-05 |