| NPI | 1164712279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95029470) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 304823-1) |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2024-10-11 |