| NPI | 1003275843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201405791) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9191709) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2016-02-22 |