| NPI | 1396457602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 95022600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95022600) |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2023-02-22 |