| NPI | 1174294433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95019298) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F04210164) |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2021-12-03 |