| NPI | 1619049103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 714940) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 263274) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-07-28 |