| NPI | 1750855425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 202010863NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 202010863NP) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2022-11-07 |