| NPI | 1639759335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 202200981NP-PP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 5380079081) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2022-03-02 |