| NPI | 1689058455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015492) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686943) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F340316) | |
| 363LF0000X Nurse Practitioner, Family (Licence: HI 2299) | |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2025-10-06 |