| NPI | 1265848196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9192764) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95006757) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2020-04-06 |