| NPI | 1457772311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95000191) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5332) |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2015-03-30 |