| NPI | 1750659793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 21204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21204) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2013-12-27 |