| NPI | 1336539857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 38639.1563) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002052) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2021-05-24 |