| NPI | 1134535180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201501757NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201501756RN) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2017-02-01 |