| NPI | 1235804857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023745) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016510) | 
| Enumeration Date | 2021-08-16 | 
| Last Update Date | 2025-06-24 |