| NPI | 1184856783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: ID 59904) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID 59904) |
| 163W00000X Registered Nurse (Licence: OR 201603681 RN) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201603682NPPP) | |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2024-05-16 |