| NPI | 1235782970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 10025470) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 6687) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-09-05 |