| NPI | 1598174591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95001299) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2285457) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2020-04-13 |