| NPI | 1295049229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 20022) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 163W00000X Registered Nurse (Licence: CA 526349) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2012-11-08 |