| NPI | 1487882072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 22493) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 267883) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN267883) | |
| 163W00000X Registered Nurse (Licence: CA 740183) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2016-01-14 |