| NPI | 1114699683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017221) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017221) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-26 |