| NPI | 1629319017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 20457) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 20457) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2018-03-17 |