| NPI | 1609416205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013588) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 143942) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2021-05-12 |