| NPI | 1407828544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 11998) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 11998) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 11998) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2016-12-30 |