| NPI | 1164727764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201503416NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60162501) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2020-12-17 |