| NPI | 1790427714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11017883) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95026876) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2025-10-01 |