| NPI | 1043860844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95012694) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 95012694) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95012694) | |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2022-01-25 |