| NPI | 1356981351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014546) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11005599) |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-08-22 |