| NPI | 1538707765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95013257) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95104781) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |