| NPI | 1205042900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15774) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA 15774) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2018-06-24 |