| NPI | 1578220612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95026439) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1059129) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2024-11-13 |