| NPI | 1568166650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10010539) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11025481) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-06-30 |