| NPI | 1366812513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000645) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001792) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2021-08-10 |