| NPI | 1083980247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 21597) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 21597) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21597) | |
| Enumeration Date | 2012-03-31 |
| Last Update Date | 2017-05-09 |