| NPI | 1720383136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201150040NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD 178752) |
| 363LF0000X Nurse Practitioner, Family (Licence: WA AP60215340) | |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2013-09-02 |