| NPI | 1366059784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95022896) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1011626) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2022-11-01 |