| NPI | 1114513116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202214567NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010051) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2022-10-06 |