| NPI | 1275066029 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95006167)  | 
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CA 550728)  | 
| 363L00000X Nurse Practitioner (Licence: CA 95006167)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95006167)  | |
| Enumeration Date | 2017-04-08 | 
| Last Update Date | 2017-04-08 |