| NPI | 1629541677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95033817) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN235670) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN235670) | |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2025-07-30 |