| NPI | 1043794969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202003147NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177229) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2020-08-07 |