| NPI | 1164973053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006211) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-29701) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2017-12-13 |