| 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 |