| NPI | 1861837007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201900779NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 642763) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2020-02-06 |