| NPI | 1043595788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95003075) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2275882) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2015-11-04 |