| NPI | 1821742230 |
|---|---|
| Former Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95031697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348997) |
| Enumeration Date | 2022-02-05 |
| Last Update Date | 2024-09-15 |