| NPI | 1225417124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95003174) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 767293) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95003174) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95003174) | |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2019-03-04 |