| NPI | 1336570076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95001702) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN/NP2277897) | 
| Enumeration Date | 2013-12-05 | 
| Last Update Date | 2015-12-29 |