| NPI | 1053620740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250083NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP20287) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2025-08-07 |