| NPI | 1841760170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010240) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 1157666) |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2019-01-23 |