| NPI | 1871040857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201702228NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024173717) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2021-11-15 |