| NPI | 1861143752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95015422) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2022-12-08 |