| NPI | 1790348019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95011537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 841741) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |