| NPI | 1114963568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200050064NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 094006506RN) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-04-17 |