| NPI | 1083614630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200050026NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200050026NP) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2020-02-11 |