| NPI | 1194901405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200850007NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 36966) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 25740.0942) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2018-03-17 |