| NPI | 1386830958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 17450) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CA 164W00000X) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2018-03-22 |