| NPI | 1205192713 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019912) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337101) | 
| Enumeration Date | 2012-04-09 | 
| Last Update Date | 2022-06-23 |