| NPI | 1295384428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95017406) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95017406) |
| 163W00000X Registered Nurse (Licence: CA 845089) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2022-04-29 |