| NPI | 1790468312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CA 95026577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95026577) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-09-01 |