| NPI | 1922519222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95007912) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55030) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2018-02-06 |