| NPI | 1255428207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 096007103RN) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 096007103N1) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2007-07-08 |