| NPI | 1104681428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95029061) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95132429) |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-04-29 |