| NPI | 1760764658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201609921NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 20441) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2020-05-07 |