| NPI | 1922001536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 092007010N3) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 092007010N3) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2021-03-22 |