| NPI | 1962769109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95007857) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 533607) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2021-12-04 |