| NPI | 1114541117 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014544) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95014544) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95014544) | |
| Enumeration Date | 2020-06-04 | 
| Last Update Date | 2022-03-30 |