| NPI | 1508051749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95000974) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 274561) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2019-10-30 |