| NPI | 1710629399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95020175) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95020175) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-12-07 |