| NPI | 1205607173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025870) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA 95025870) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95025870) | |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |