| NPI | 1508204090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002840) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4998) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2015-09-10 |