| NPI | 1568075596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014296) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014296) | 
| Enumeration Date | 2020-08-28 | 
| Last Update Date | 2023-03-02 |