| NPI | 1033490784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250107NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200842023RN) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2020-01-20 |