| NPI | 1326645417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 202010122NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200040937RN) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2021-12-15 |