| NPI | 1275008021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10014268) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2328120) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2024-04-19 |