| NPI | 1619562170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 202011147NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 2020012418) |
| 363LS0200X Nurse Practitioner School (Licence: OR 2020012418) | |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2022-02-04 |