| NPI | 1861915993 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011416) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07170933) | 
| Enumeration Date | 2017-07-20 | 
| Last Update Date | 2022-01-18 |