| NPI | 1003916636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95010735) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP-763A) |
| 363L00000X Nurse Practitioner (Licence: OR 201150140NP) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2319223) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2025-02-03 |