| NPI | 1104520501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025425) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 13770-33) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-01-14 |