| NPI | 1083352744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95020287) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95266217) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95020287) | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-05-23 |