| NPI | 1356795504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201701664NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 29710.1511) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2020-07-13 |