| NPI | 1619492436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95022746) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174986) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2022-09-27 |