| NPI | 1619515830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95013823) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95070886) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2022-05-31 |