| NPI | 1528808318 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95028085)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95356663)  | 
| Enumeration Date | 2024-05-29 | 
| Last Update Date | 2024-06-05 |