| NPI | 1154612331 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 21993)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011004780)  | 
| Enumeration Date | 2011-04-22 | 
| Last Update Date | 2017-10-11 |