| NPI | 1063994275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014004) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704197649) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2020-02-26 |