| NPI | 1538426325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95000868) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2012010797) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2018-05-17 |