| NPI | 1053342279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200450006NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 089003375N3) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-05-03 |