| NPI | 1710498035 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28752) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008434) | 
| Enumeration Date | 2017-10-12 | 
| Last Update Date | 2025-06-04 |