| NPI | 1104362052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95028113) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-142816) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95028113) | |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2025-12-23 |