| NPI | 1396200762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014742) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F06182373) |
| Enumeration Date | 2019-02-09 |
| Last Update Date | 2021-03-16 |