| NPI | 1962976597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95012650) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95138229) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-05-11 |