| NPI | 1649817016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95015949) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 11002390) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2021-01-22 |