| NPI | 1558781112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010578) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 764748) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-02-01 |