| NPI | 1518155175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 332272) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 16946) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |