| NPI | 1104337419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019277) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135462) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2022-01-18 |