| NPI | 1174912752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95001579) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN 284796) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-02-06 |