| NPI | 1629085113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 336318) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 336318) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-12 |