| NPI | 1104205871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95006502) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 339478) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2025-06-10 |