| NPI | 1417200908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 19169) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 19169) |
| 163W00000X Registered Nurse (Licence: CA 673910) | |
| Enumeration Date | 2012-10-21 |
| Last Update Date | 2017-09-05 |