| NPI | 1124660154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 362422-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 362422-3102) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 10021529) | |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2024-02-14 |