NPI | 1174054308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201900999NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201402959RN) |
Enumeration Date | 2017-03-21 |
Last Update Date | 2019-07-12 |