| NPI | 1255987517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95012424) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95137673) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2021-12-07 |