| NPI | 1699718163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 201909193NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP009024) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-03-10 |