| NPI | 1770564981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA RN048306) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 447) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |