| NPI | 1003064304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201050104NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 18370) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2016-03-28 |