| NPI | 1902458367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95012707) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA AG05190040) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2021-03-25 |