| NPI | 1063298875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95026202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95260463) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95026202) | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |