| NPI | 1811921257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 15124) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA 60572096) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-09-03 |