| NPI | 1841706769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95008168) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95008168) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP09818) | |
| Enumeration Date | 2017-12-15 | 
| Last Update Date | 2022-05-31 |