| NPI | 1235608548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202007509NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 8594) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2022-02-28 |