| NPI | 1801520200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202213843NPPP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1075814) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-07-29 |