| NPI | 1093110306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10019535) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5965-33) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2024-05-09 |