| NPI | 1336109248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 11613)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 374606)  | 
| Enumeration Date | 2006-03-24 | 
| Last Update Date | 2018-03-12 |