| NPI | 1154579290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 16646) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 16646) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2020-11-11 |