| NPI | 1679031595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95011239) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2019037461) |
| Enumeration Date | 2019-03-10 |
| Last Update Date | 2022-05-19 |