| NPI | 1184618860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 083039540N1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 083039540N1) |
| 363L00000X Nurse Practitioner (Licence: ID NP200A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 083039540N1) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP200A) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: ID NP200A) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2010-08-31 |