| NPI | 1023588076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011401) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95158152) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95011401) | |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2020-12-30 |