| NPI | 1174030506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007845) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA NP95007845) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2019-12-11 |