| NPI | 1639647241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22564) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010376) |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2019-05-24 |