| NPI | 1053708545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201609981NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 20593.1386) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2018-10-09 |