| NPI | 1699218636 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011013) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132430) | 
| 363LF0000X Nurse Practitioner, Family (Licence: ND R43934) | |
| Enumeration Date | 2016-11-23 | 
| Last Update Date | 2025-09-24 |