| NPI | 1679916738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201505056NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI 1517) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2021-03-11 |