| NPI | 1710467527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95018640) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95103874) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95018640) | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-03-01 |