| NPI | 1104495761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 745030) |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-06-18 |