| NPI | 1902061906 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 18533)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008485)  | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 18533)  | |
| Enumeration Date | 2008-07-19 | 
| Last Update Date | 2025-05-01 |