| NPI | 1336372226 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 19060) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 685009) | 
| Enumeration Date | 2009-08-26 | 
| Last Update Date | 2009-08-26 |