| NPI | 1114392842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201905115NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201041541RN) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI 2999) | |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2020-11-29 |