| NPI | 1073911210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014684) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2289776) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6693) | |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2025-08-06 |