| NPI | 1154613941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 201250059) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 096000646) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201250059NP) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2019-08-02 |