| NPI | 1982654844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP11055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP11055) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA NP11055) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-09 |