| NPI | 1477887610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 104058-5880) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 22634) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2013-03-01 |