| NPI | 1356607931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 20120079NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 990369) |
| Enumeration Date | 2012-04-08 |
| Last Update Date | 2012-09-13 |