| NPI | 1144640293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201602750NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CT 5720) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95002389) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2018-01-02 |