| NPI | 1679628150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 5034) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP2735) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2013-04-17 |