| NPI | 1104835297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200750071NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60063158) |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2024-01-28 |