| NPI | 1700395001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007833) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135249) |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2022-07-21 |