| NPI | 1902484751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10006558) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181097) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2023-07-19 |