| NPI | 1386153633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201708936NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 57882) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2020-08-20 |