| NPI | 1760859995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201901366NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 15987-1395) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 99694) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2019-10-09 |