| NPI | 1639736770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022012950) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010622) | 
| Enumeration Date | 2019-05-23 | 
| Last Update Date | 2024-09-17 |