| NPI | 1124443676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NE 111628) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 201501818NP-PP) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2022-09-16 |