| NPI | 1073943551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95083773) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111603) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2023-03-07 |