| NPI | 1720562564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95009950) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NC 5012868) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2020-06-24 |