| NPI | 1679192561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014743) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95014743) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95014743) | |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2022-02-11 |