| NPI | 1639880321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95029081) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NV RN99178) |
| 363LF0000X Nurse Practitioner Family (Licence: NV 861919) | |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2024-07-02 |