| NPI | 1114379120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008716) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 716661) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2018-06-13 |