| NPI | 1134561814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201800340NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23228) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2020-10-12 |