| NPI | 1376279323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202215285NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1061486) |
| 363L00000X Nurse Practitioner (Licence: WA 61302785) | |
| Enumeration Date | 2022-07-30 |
| Last Update Date | 2023-06-20 |