| 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 |