| NPI | 1417931668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP4000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN231823) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |