| NPI | 1104834720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 084055153N3) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: OR 084055153RN) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |