| NPI | 1710281233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 18343) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA 18343) |
| 261QX0200X Clinic/Center, Oncology (Licence: CA 18343) | |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2012-04-03 |