| NPI | 1790947653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95014005) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4396) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F335503) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-10-19 |