| NPI | 1588061048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201508553NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 991948) |
| Enumeration Date | 2014-11-28 |
| Last Update Date | 2022-03-08 |