| NPI | 1124386396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 404843) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA12109) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |