| NPI | 1497270201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95015649) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95015649) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9464030) | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2023-06-28 |