| NPI | 1417494055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95025276) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 6632461-3102) |
| 163W00000X Registered Nurse (Licence: AK 115158) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 115159) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95025276) | |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2024-08-02 |