| NPI | 1700390721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201710156NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9344290) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2018-03-17 |