| NPI | 1275068801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95006537) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 95006537) |
| 363L00000X Nurse Practitioner (Licence: KS 53-77553-111) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA NP95006537) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2026-01-12 |