| NPI | 1942815998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015466) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015466) |
| 163W00000X Registered Nurse (Licence: CA 95173512) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2022-03-02 |