| NPI | 1093201568 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023011) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP137937) | 
| Enumeration Date | 2018-07-07 | 
| Last Update Date | 2024-08-07 |