| NPI | 1841669967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201806089NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009671) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2019-02-15 |