| NPI | 1073995999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201804011NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 89619) |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-09-10 |