NPI | 1073053351 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10007710) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201605242RN) |
Enumeration Date | 2017-03-06 |
Last Update Date | 2024-07-15 |