| NPI | 1255511143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 553) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: CA 268435) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |