| NPI | 1215546767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95017081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2328901) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2023-04-01 |