| NPI | 1356879878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95006660) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN221346) |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2017-05-29 |