| NPI | 1962770958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95001735) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2108078) |
| 363LF0000X Nurse Practitioner, Family (Licence: NV APN001344) | |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2021-03-30 |