| NPI | 1265524482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250090NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 332374) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-01-23 |