| NPI | 1790056380 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95023802) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023802) | 
| 363LF0000X Nurse Practitioner, Family (Licence: OK R0089445) | |
| Enumeration Date | 2012-01-13 | 
| Last Update Date | 2025-09-17 |