| NPI | 1366057101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 202010019NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA 363L00000X) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2021-05-07 |