| NPI | 1548908866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95028129) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11020947) |
| 363LF0000X Nurse Practitioner Family (Licence: ID 75661) | |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2023-11-23 |