| NPI | 1912343526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95000094) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 584953) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2014-01-27 |