| NPI | 1093715930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 099007166) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 099007166N1) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2018-05-18 |