| NPI | 1699399196 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014566)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95014566)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: ID 75758)  | |
| Enumeration Date | 2020-06-01 | 
| Last Update Date | 2023-03-28 |