| NPI | 1720624158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95012874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012022A) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-07-25 |