| NPI | 1629188818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007553) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP128129) |
| 363L00000X Nurse Practitioner (Licence: IL 209001147) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-02-05 |