| NPI | 1164762670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA F0713681) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22540) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2013-10-04 |