| NPI | 1639258296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 14430) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 544392) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2013-11-19 |