| NPI | 1104136696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 683686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR ATP-000307) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 683686) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2022-11-03 |