| NPI | 1366707713 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025723) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 901939) | 
| Enumeration Date | 2012-07-11 | 
| Last Update Date | 2023-09-25 |