| NPI | 1114489093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10025675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-145742) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-09-30 |