| NPI | 1700122124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250081NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95013020) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2024-01-31 |