| NPI | 1942543749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201902556NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4911) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2019-05-22 |