| NPI | 1629405691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000230) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704281936) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2014-04-16 |