| NPI | 1124638697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95015784) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95099034) |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2020-11-16 |