| NPI | 1588264360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95172682) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |