| NPI | 1245419399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 200750097NP FNP-PP) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 200750097NP) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2015-01-16 |