| NPI | 1235686411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 202101776NP-PP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 307808) |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2022-10-06 |