| NPI | 1528504107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004963) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: CA 95004963) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95004963) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95004963) | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |