| NPI | 1629706106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95022136) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 846058) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95022136) | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-02-13 |