| NPI | 1740619063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015731) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 600765) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 345063) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2025-03-25 |