| NPI | 1518203314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95000139) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 711523) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95000139) | |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2017-11-13 |