| NPI | 1114901279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008948) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 141587) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2018-10-02 |