| NPI | 1578105789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95012814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95012814) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-09-02 |