| NPI | 1649213034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18504) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024069675) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-04-03 |