| NPI | 1053706341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA FURNISHING #:4034) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA RN;329657) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |