| NPI | 1801353305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011177) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95011177) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |