| NPI | 1982113460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010765) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2304239) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2024-12-27 |