| NPI | 1164838629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201500188NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1446A) |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2020-06-03 |