| NPI | 1588242002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017979) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71010996A) | 
| Enumeration Date | 2021-03-29 | 
| Last Update Date | 2021-08-17 |