| NPI | 1669979761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95013657) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2320451) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2026-06-05 |