| NPI | 1073513453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OR 092000112RN) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 092000112N1) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2015-07-06 |