| NPI | 1144409699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 20157) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003693) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003693) | |
| Enumeration Date | 2007-11-01 | 
| Last Update Date | 2020-09-16 |