| NPI | 1184670788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200250011NPPP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200250011NP) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-06-02 |