| NPI | 1578180857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 202007387NP-PP)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 26844)  | 
| Enumeration Date | 2020-07-02 | 
| Last Update Date | 2020-08-14 |