| NPI | 1083015234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 02604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 824958) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95001278) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2015-01-24 |