| NPI | 1861877037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017501) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A141009) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F342964) | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2021-10-14 |