| NPI | 1053719492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95001849) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9275392) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2016-03-25 |