| NPI | 1275522518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 13931) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024129018) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2010-12-13 |