| NPI | 1619349966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201908978NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R190125) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2021-10-08 |