| NPI | 1902941222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201809302NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2273) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2019-11-06 |