| NPI | 1316958770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA RN 229200 NP 16404) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704124126) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |