| NPI | 1477678050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 11586) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 11586) |
| 363A00000X Physician Assistant (Licence: CA PA15415) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2012-01-24 |