| NPI | 1003096611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008145) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 204) |
| 363L00000X Nurse Practitioner (Licence: OR 201150037NP) | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2016-02-29 |