| NPI | 1295092765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201408155NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61350628) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-10-11 |