| NPI | 1003379306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95028550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704310872) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5019136) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-01-12 |