| NPI | 1255349783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 075034895N3) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2007-07-08 |