| NPI | 1962833004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004903) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 123850) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2020-01-15 |