| NPI | 1164140281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 70287) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 70287) |
| 363L00000X Nurse Practitioner (Licence: CA 95015168) | |
| 207Q00000X Family Medicine (Licence: CA 644524) | |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2025-12-05 |