| NPI | 1699401414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021060) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CA 95021060) |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2023-01-04 |