| NPI | 1215553938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017142) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 242014) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2022-11-03 |