| NPI | 1154604494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21735) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28196379A) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2014-06-17 |