| NPI | 1194065847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009752) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95009752) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95009752) | |
| Enumeration Date | 2013-02-17 |
| Last Update Date | 2021-01-27 |