| NPI | 1740728831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 95006140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006140) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2024-07-10 |