| NPI | 1154339679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200450101NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 200241905RN) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2019-01-02 |