| NPI | 1790237485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95005154) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95005154) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2018-06-11 |