NPI | 1215919436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200441587RN) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 200450134NP) |
363L00000X Nurse Practitioner (Licence: OR 200450133NP) | |
Enumeration Date | 2005-11-15 |
Last Update Date | 2007-10-18 |