| NPI | 1609206523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178910) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001293135) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 23757) | |
| 163W00000X Registered Nurse (Licence: CA 788745) | |
| 363L00000X Nurse Practitioner (Licence: CO C-APN.0105399-C-NP) | |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2026-01-16 |