| NPI | 1245889310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95012573) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95012573) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95012573) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |