| NPI | 1629136841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201909925NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 0050-02045) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-08-13 |