| NPI | 1124639315 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014333)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014333)  | 
| Enumeration Date | 2020-08-12 | 
| Last Update Date | 2020-09-26 |