| NPI | 1700180098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP66749) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201604412NP-PP) |
| Enumeration Date | 2010-12-31 |
| Last Update Date | 2021-04-13 |