| NPI | 1225264153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 200950059NP) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: OR 200950059NP) |
| 363L00000X Nurse Practitioner (Licence: MN CNP3905) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2022-02-22 |