| NPI | 1679028658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004778) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 95004778) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2022-06-01 |