| NPI | 1104290501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP95002465) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 843999) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP95002465) | |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2020-06-03 |