| NPI | 1255423158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250060NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 14329) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2012-08-06 |