| NPI | 1861466971 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000863)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30007119)  | 
| Enumeration Date | 2006-02-15 | 
| Last Update Date | 2020-06-24 |