| NPI | 1073542056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 57502) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP9976) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2019-04-08 |