| NPI | 1861791550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011415) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 10357) |
| 363L00000X Nurse Practitioner (Licence: WA 60924072) | |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2020-06-19 |