| NPI | 1962068304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95011171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95011171) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2022-05-25 |