| NPI | 1245603174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003351) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61116932) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 173480) | |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2021-03-31 |