| NPI | 1912793977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95039154) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: CA 95366693) |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2026-08-20 |