| NPI | 1962750208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 20200540NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201043206RN) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-11-28 |