| NPI | 1902139462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201150170NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN280650) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2021-03-25 |