| NPI | 1780861609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 13992) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: CA 1800) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |