| 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 |