| NPI | 1710521646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95016309) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95023613) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2021-01-28 |