| NPI | 1659765212 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95007981)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687133)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307594)  | |
| Enumeration Date | 2015-03-22 | 
| Last Update Date | 2021-10-04 |