| NPI | 1104196930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 19705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV APN001042) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |