| NPI | 1194067694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202210059NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 742193) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2022-08-03 |