| NPI | 1871539064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R136202) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP13979) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2013-03-04 |