| NPI | 1629809967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95031552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11033819) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-10-16 |