| NPI | 1194125211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95001232) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP95001232) |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2016-01-18 |