| NPI | 1114159068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 200950101NP FNP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: HI APRN1836) |
| 363L00000X Nurse Practitioner (Licence: OR 200950101NP FNP-PP) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2023-10-23 |