| NPI | 1548708720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95004874) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95004874) | |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |