| NPI | 1992135081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 23622) |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care (Licence: CA 23622) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-12-10 |