| NPI | 1073990859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95001362) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95001362) | 
| Enumeration Date | 2015-04-30 | 
| Last Update Date | 2019-01-21 |