| NPI | 1083091029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201601264NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-054204) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-054204) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2020-08-06 |