| NPI | 1962748954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95014490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 16990) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2020-07-10 |