| NPI | 1124785480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 202113642NP-PP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1048720) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2022-03-11 |