| NPI | 1912151192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 18076) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 18076) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2015-08-06 |