| NPI | 1699059253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QA0005X Clinic/Center Ambulatory Family Planning Facility (Licence: CA 543710) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 543710) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2012-02-15 |