| NPI | 1255684429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-1635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI 1635) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 22541) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2020-10-14 |