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 |