| NPI | 1083009872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201501752NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 201501751RN) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201501752NP-PP) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-03-22 |