| NPI | 1841803616 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202011044NP) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A160511) | 
| Enumeration Date | 2020-08-31 | 
| Last Update Date | 2022-10-26 |