| NPI | 1023377397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201405292NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R199800) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9221193) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 3984) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2022-10-24 |