| NPI | 1528461779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004323) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02525) |
| 363A00000X Physician Assistant (Licence: CA 95004323) | |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2021-05-10 |