| NPI | 1740563675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WA N361205317) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 201150107NP) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2021-11-07 |