| NPI | 1952776205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95002033) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 95002033) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2019-08-26 |