| NPI | 1649837907 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011704) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10044077) | 
| Enumeration Date | 2019-05-22 | 
| Last Update Date | 2025-10-20 |