| NPI | 1609904853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202000800NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-62495) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2022-07-06 |