| NPI | 1790313047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006661)  | 
| Additional Taxonomies | 163WI0500X Registered Nurse, Infusion Therapy (Licence: CA 95006661)  | 
| Enumeration Date | 2020-03-31 | 
| Last Update Date | 2022-02-11 |