| NPI | 1972780997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 204110) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 304313) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2011-08-03 |