| NPI | 1760004055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004949) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014332) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-09-06 |