| NPI | 1063895340 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9199571)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95027940)  | 
| Enumeration Date | 2015-07-03 | 
| Last Update Date | 2024-10-11 |