| NPI | 1174963821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008468) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 7289) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 740228) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3008093) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2025-10-10 |