| NPI | 1871130419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202205783NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2337048) |
| 163W00000X Registered Nurse (Licence: OR 202205726RN) | |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2022-07-12 |