| NPI | 1215690698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95019172) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704309836) |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-11-17 |