| NPI | 1770819104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 829557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71003085A) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2012-12-03 |