| NPI | 1104807619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA FNP7509) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA FNP7509) |
| 363L00000X Nurse Practitioner (Licence: CA RN306836) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2014-05-19 |