| NPI | 1255981593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 232368) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95012253) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2021-12-02 |