| NPI | 1063759496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95019881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AK 189947) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 604251) | |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2022-05-26 |