| NPI | 1538420971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201402770NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 28919.1185) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2020-11-04 |