| NPI | 1104485580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017491) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX ap140783) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2021-10-15 |