| NPI | 1194815472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95089327) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 107801) |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2019-04-16 |