| NPI | 1619558442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 61338354) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA 61338354) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95017012) | |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2025-05-27 |