| NPI | 1073986436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202000950NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129491) |
| Enumeration Date | 2015-11-07 |
| Last Update Date | 2020-02-24 |