| NPI | 1730623083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005346) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172136) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0995106) | |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2020-09-22 |