| NPI | 1013050301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 099006422N1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 099006422RN) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2021-10-07 |