| NPI | 1104199546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA NP1584) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: CA NP1584) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA NP1584) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |