| NPI | 1629680673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95016460) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95222840) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95016460) | |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2021-05-18 |