| NPI | 1639441264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250100NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 201500-4405) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2018-08-27 |