| NPI | 1710382239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011121) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2020-06-03 |