| NPI | 1053400424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 173274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21574) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-04-26 |