| NPI | 1922640184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95013363) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013846) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-11-20 |