| NPI | 1275811549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201601936NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2264435) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2016-07-19 |