| NPI | 1073839858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336195) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2014-06-18 |