| NPI | 1164071858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202004995NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 7010) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2023-08-01 |