| NPI | 1154642700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201050070NP) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: OR 200770014CNS) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-12-03 |