| NPI | 1760779953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 201904219NP-PP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 19947) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2019-10-04 |