| NPI | 1720643562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023913) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001886) |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2023-06-15 |