| NPI | 1750788113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OR 201905492NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60648561) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP125330) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2019-09-25 |