| NPI | 1548883002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017155)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA F05200314)  | 
| Enumeration Date | 2020-05-19 | 
| Last Update Date | 2021-06-25 |