| NPI | 1124516646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95008704) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95035694) |
| 207Q00000X Family Medicine (Licence: CA F04180316) | |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |