| NPI | 1821699521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA NP95013815) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CA NP95013815) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CA NP95013815) | |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2021-03-10 |