| NPI | 1770821217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21694) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337209) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-22 |