| NPI | 1306036009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 164299) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: OR 200340596RN) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3490) | |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2022-07-25 |