| NPI | 1902014111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 12385) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 537766) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2020-11-23 |