| NPI | 1578546628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP 01770) |
| Additional Taxonomies | 2086S0129X (Licence: CA NP8903) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2011-04-12 |