| NPI | 1427724962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95018385) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1048213) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2022-01-11 |