| NPI | 1417596016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201908784NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61006464) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |