| NPI | 1164406757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 484123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 15697) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2016-01-07 |