| NPI | 1255974051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95013021) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95013021) |
| 363L00000X Nurse Practitioner (Licence: CA 95013021) | |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |