| NPI | 1659478659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201405164NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 30023.1143) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-06-19 |