| NPI | 1790049146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95006229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F1216066) |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2021-11-02 |