| NPI | 1063078806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95079580) |
| 363L00000X Nurse Practitioner (Licence: CA 95009121) | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2023-08-16 |