| NPI | 1619332608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017006199) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003540) |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2021-06-24 |