| NPI | 1356715304 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95034248)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013356)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179220)  | |
| Enumeration Date | 2015-11-13 | 
| Last Update Date | 2025-05-27 |