| NPI | 1245370840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004412) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 56464) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024165166) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2025-10-10 |