| NPI | 1972070662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 95010273) |
| 363L00000X Nurse Practitioner (Licence: CA NPF95010273) | |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2022-10-05 |