| NPI | 1992181176 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011789) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7962) | 
| Enumeration Date | 2015-08-10 | 
| Last Update Date | 2023-10-12 |