| NPI | 1740020643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95035195) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN29893) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2026-01-13 |