| NPI | 1871963835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95003312) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52910) |
| Enumeration Date | 2015-10-03 |
| Last Update Date | 2016-10-12 |