| 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 |