| NPI | 1710909874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201900061NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 15690) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-10-21 |