| NPI | 1326773946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015058) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 95015058) |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CA 95015058) | |
| Enumeration Date | 2022-07-18 |
| Last Update Date | 2022-09-13 |