| NPI | 1922538818 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95006188) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95005188) | 
| Enumeration Date | 2017-06-14 | 
| Last Update Date | 2017-12-15 |