| NPI | 1619966355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201150045 NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 600771) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 13823) | |
| Enumeration Date | 2005-10-16 |
| Last Update Date | 2014-04-30 |