| NPI | 1790075653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 20290) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336147) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |