| NPI | 1558619015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95016792) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP121988) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2022-03-08 |