| NPI | 1114494705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202004346NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6166) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2020-08-14 |