| NPI | 1659624948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 21536) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 21536) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-08-21 |