| NPI | 1801488143 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015986) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95015986) | 
| 2085R0001X (Licence: CA 95015986) | |
| Enumeration Date | 2021-02-08 | 
| Last Update Date | 2023-07-17 |