| NPI | 1609290063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201904774NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 0000443-C-NP) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 751545) | |
| 363LX0106X Nurse Practitioner Occupational Health (Licence: OR 201904774NP-PP) | |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2021-07-27 |