| NPI | 1174650758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 607935(LICENSE)15204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA RN607935) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-06-07 |