| NPI | 1245211374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 096006313N3) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 096006313N3) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: OR 096006313N7) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2018-10-08 |