| NPI | 1679110464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95018797) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704328368) |
| Enumeration Date | 2019-11-29 |
| Last Update Date | 2023-04-24 |