| NPI | 1174911390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 261021) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001461) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2023-02-15 |