| NPI | 1649574443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201600700NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 20366) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2021-03-29 |